A New Integrative Modeling Approach for Generating Counterfactual Projections of Colorectal Cancer Incidence Rates in the Absence of Organized Screening in Australia

Qingwei Luo, Jie-Bin Lew, Joachim Worthington, Clare Kahn, Han Ge, Emily He, Michael Caruana, Michael David, Dianne L O’Connell, Karen Canfell, Julia Steinberg and Eleonora Feletto
Additional contact information
Qingwei Luo: The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
Jie-Bin Lew: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Joachim Worthington: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Clare Kahn: The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
Han Ge: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Emily He: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Michael Caruana: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Michael David: The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
Dianne L O’Connell: The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
Karen Canfell: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Julia Steinberg: The Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, NSW, Australia
Eleonora Feletto: Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

Medical Decision Making, 2026, vol. 46, issue 2, 189-201

Abstract: Background The Australian National Bowel Cancer Screening Program (NBCSP), which provides 2-yearly screening to people aged 50 to 74 y, had a phased rollout from 2006 and was fully implemented in 2020. To measure the effectiveness of the NBCSP accounting for age-specific trends, we aimed to develop a novel integrative method to project colorectal cancer (CRC) incidence rates from 2006 to 2045 in the absence of the NBCSP (referred to as “no-NBCSP projections†) while addressing the challenge of complex age-specific trends in CRC incidence. Methods We constructed a new dataset by replacing the observed data for NBCSP-eligible individuals aged 50 to 74 y with intermediate projections based on pre-NBCSP data from 1982 to 2005. We compared the no-NBCSP CRC incidence projected using a standard age-period-cohort (APC) model, age-stratified APC models, and the integrative modeling approach. Results The integrative modeling approach captured complex age-specific trends better than the standard and age-stratified APC models did. Without the NBCSP, the overall CRC incidence rates would be expected to decline from 2005 to 2025, followed by increases from 2026 to 2045. The incidence rates for those aged

Keywords: colorectal cancer; incidence; counterfactual projections; cancer screening; age-period-cohort model; Australia (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:46:y:2026:i:2:p:189-201

DOI: 10.1177/0272989X251393257

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